Multidisciplinary care planning in the primary care management of completed stroke: a systematic review

Mitchell, Geoffrey K., Brown, Robyn M., Erikssen, Lars and Tieman, Jennifer J. (2008) Multidisciplinary care planning in the primary care management of completed stroke: a systematic review. BMC Family Practice, 9 Article Number: 44. doi:10.1186/1471-2296-9-44


Author Mitchell, Geoffrey K.
Brown, Robyn M.
Erikssen, Lars
Tieman, Jennifer J.
Title Multidisciplinary care planning in the primary care management of completed stroke: a systematic review
Journal name BMC Family Practice   Check publisher's open access policy
ISSN 1471-2296
Publication date 2008-08-05
Year available 2008
Sub-type Article (original research)
DOI 10.1186/1471-2296-9-44
Open Access Status DOI
Volume 9
Start page Article Number: 44
Total pages 10
Editor Melissa Norton
Place of publication London, England
Publisher BioMed Central
Language eng
Subject C1
920103 Cardiovascular System and Diseases
111717 Primary Health Care
Abstract Background: Chronic disease management requires input from multiple health professionals, both specialist and primary care providers. This study sought to assess the impact of co-ordinated multidisciplinary care in primary care, represented by the delivery of formal care planning by primary care teams or shared across primary-secondary teams, on outcomes in stroke, relative to usual care.
Formatted abstract
Background: Chronic disease management requires input from multiple health professionals, both specialist and primary care providers. This study sought to assess the impact of co-ordinated multidisciplinary care in primary care, represented by the delivery of formal care planning by primary care teams or shared across primary-secondary teams, on outcomes in stroke, relative to usual care.

Methods: A Systematic review of Medline, EMBASE, CINAHL (all 1990-2006), Cochrane Library (Issue 1 2006), and grey literature from web based searching of web sites listed in the CCOHA Health Technology Assessment List Analysis used narrative analysis of findings of randomised and non-randomised trials, and observational and qualitative studies of patients with completed stroke in the primary care setting where care planning was undertaken by 1) a multi-disciplinary primary care team or 2) through shared care by primary and secondary providers.

Results: One thousand and forty-five citations were retrieved. Eighteen papers were included for analysis. Most care planning took part in the context of multidisciplinary team care based in hospitals with outreach to community patients. Mortality rates are not impacted by multidisciplinary care planning. Functional outcomes of the studies were inconsistent. It is uncertain whether the active engagement of GPs and other primary care professionals in the multidisciplinary care planning contributed to the outcomes in the studies showing a positive effect. There may be process benefits from multidisciplinary care planning that includes primary care professionals and GPs. Few studies actually described the tasks and roles GPs fulfilled and whether this matched what was presumed to be provided.

Conclusion: While multidisciplinary care planning may not unequivocally improve the care of patients with completed stroke, there may be process benefits such as improved task allocation between providers. Further study on the impact of active GP involvement in multidisciplinary care planning is warranted.
Keyword Primary Health Care
Medicine, General & Internal
General & Internal Medicine
MEDICINE, GENERAL & INTERNAL
PRIMARY HEALTH CARE
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
Discipline of General Practice Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 16 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 18 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 14 Apr 2009, 04:13:46 EST by Gillian Vey on behalf of General Practice SOMC